States May Give Nurse Practitioners More Authority

April 14, 2010

With the U.S. facing a shortage of primary care physicians, several states are considering giving more authority to nurse practitioners, according to an April 13 article by AP Medical Writer Carla K. Johnson.

By definition, a nurse practitioner is a registered nurse who has completed an advanced medical education program, usually resulting in a master’s or doctorate degree. They are trained in the diagnosis and treatment of most common medical conditions, and are currently allowed to treat a limited number of mental or physical ailments and provide other health care services.

However, due to a predicted shortage of doctors and more than 30 million individuals gaining access to medical insurance due to the recently signed health care reform law, 28 states are considering passing statutes that will help nurse-managed clinics fill the primary care void–a move that will be funded in part by the health care legislation, which earmarks $50 million in funds for nurse-managed clinics that offer medical care to lower-income patients and an additional $50 million to help hospitals train nurse practitioners so that they can diagnose and treat Medicare patients.

“The medical establishment is fighting to protect turf,” Johnson writes. “In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.”

“Nurse practitioners argue there’s no danger,” she continues. “They say they’re highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.”

Regulations governing what responsibilities a nurse practitioner can have currently vary by state. For example, Alabama and Florida prohibit them from prescribing controlled substances, though Florida’s legislature is considering a bill that would alter that policy. On the other hand, nurse practitioners in Montana do not need to have a doctor associated with their practice in any way, though most states require that doctors be placed in charge of or collaborate with their practices.